Self-Injection Device

ABSTRACT

A drug delivery device ( 100 ), including a body ( 104, 116 ) having a reservoir ( 164, 176 ) disposed therein for containing a medicament and an injection needle ( 152 ) for penetrating the skin of a patient, the needle ( 152 ) providing a path for the medicament between the reservoir ( 164, 176 ) and the patient. The device ( 100 ) also includes a needle cover ( 114 ) for selectively covering the injection needle ( 152 ), an adhesive ( 264 ) for selectively adhering the device to the patient, a release liner ( 500 ) for selectively covering a patient side of the adhesive ( 264 ), and a connecting means ( 112, 520, 512, 508, 524 ) for connecting the needle cover ( 114 ) and the release liner ( 500 ) such that removal of one of the needle cover ( 114 ) and the release liner ( 500 ) from the device ( 100 ) removes the other one of the needle cover ( 114 ) and the release liner ( 500 ).

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.13/516,540, filed Jun. 15, 2012 in the U.S. Patent and Trademark Office,which is a national stage application of International PatentApplication No. PCT/US09/06573, filed Dec. 16, 2009 in the U.S. Patentand Trademark Office. The disclosures of both applications areincorporated herein by reference in their entirety.

FIELD OF THE INVENTION

The present invention relates generally to a substance delivery devicehaving improved patient convenience, ease of use, and efficiency. Thepresent invention also relates generally to a patch-like, self-containedsubstance infusion or self-injection device that can be used to delivera variety of substances or medications to a patient. More specifically,the present invention relates to a patch-like infusion or self-injectiondevice with integrated removal of a needle cover and an adhesive releaseliner.

BACKGROUND OF THE INVENTION

A large number of people, such as those suffering from conditions suchas diabetes, use some form of infusion therapy, such as daily insulininfusions, to maintain close control of their glucose levels. Currently,in the insulin infusion treatment example, there are two principal modesof daily insulin therapy. The first mode includes syringes and insulinpens. These devices are simple to use and are relatively low in cost,but they require a needle stick at each injection typically three tofour times per day. The second mode includes infusion pump therapy,which entails the purchase of an expensive pump that lasts for aboutthree years. The high cost (roughly 8 to 10 times the daily cost ofsyringe therapy) and limited lifetime of the pump are high barriers tothis type of therapy. Insulin pumps also represent relatively oldtechnology and are cumbersome to use. From a lifestyle standpoint,moreover, the tubing (known as the “infusion set”) that links the pumpwith the delivery site on the patient's abdomen is very inconvenient andthe pumps are relatively heavy, making carrying the pump a burden. Froma patient perspective, however, the overwhelming majority of patientswho have used pumps prefer to remain with pumps for the rest of theirlives. This is because infusion pumps, although more complex thansyringes and pens, offer the advantages of continuous infusion ofinsulin, precision dosing and programmable delivery schedules. Thisresults in closer glucose control and an improved feeling of wellness.

Interest in better therapy is on the rise, accounting for the observedgrowth in pump therapy and increased number of daily injections. In thisand similar infusion examples, what is needed to fully meet thisincreased interest is a form of insulin delivery or infusion thatcombines the best features of daily injection therapy (low cost and easeof use) with those of the insulin pump (continuous infusion andprecision dosing) and that also avoids the disadvantages of each.

Several attempts have been made to provide ambulatory or “wearable” druginfusion devices that are low in cost and convenient to use. Some ofthese devices are intended to be partially or entirely disposable. Intheory, devices of this type can provide many of the advantages of aninfusion pump without the attendant cost and inconvenience.Unfortunately, however, many of these devices suffer from disadvantagesincluding patient discomfort (due to the gauge and/or length ofinjection needle used), compatibility and interaction between thesubstance being delivered and the materials used in the construction ofthe infusion device, and possible malfunctioning if not properlyactivated by the patient (for example, “wet” injections resulting frompremature activation of the device). Difficulties in manufacturing andin controlling needle penetration depth have also been encountered,particularly when short and/or fine-gauge injection needles are used.The possibility of needle-stick injuries to those who come into contactwith the used device has also been problematic.

Accordingly, a need exists for an alternative to current infusiondevices, such as infusion pumps for insulin, that further providessimplicity in manufacture and use improvements for insulin andnon-insulin applications.

SUMMARY OF THE INVENTION

An aspect of the present invention is to provide a patch-like infusionor self-injection device that can be conveniently worn against the skinwhile providing infusion of a desired substance, and providing minimaldiscomfort by using one or more microneedles. An additional aspect ofthe present invention is to provide such an infusion or self-injectiondevice in which removal of a needle cover and an adhesive release linerof such an infusion or self-injection device can be integrated into asingle operation.

The foregoing and/or other aspects of the present invention are achievedby providing a drug delivery device, including a body having a reservoirdisposed therein for containing a medicament and an injection needle forpenetrating the skin of a patient, the needle providing a path for themedicament between the reservoir and the patient. The device alsoincludes a needle cover for selectively covering the injection needle,an adhesive for selectively adhering the device to the patient, arelease liner for selectively covering a patient side of the adhesive,and a connecting means for connecting the needle cover and the releaseliner such that removal of one of the needle cover and the release linerfrom the device removes the other one of the needle cover and therelease liner from the device.

The foregoing and/or other aspects of the present invention are alsoachieved by providing a drug delivery device, including an injectionneedle for penetrating the skin of a patient, an adhesive forselectively adhering the device to the patient, a release liner forselectively covering a patient side of the adhesive, the release linerhaving an opening therein, and a needle cover for selectively coveringthe injection needle. The needle cover includes a needle-coveringportion with a flange larger than the release liner opening, a middleportion positioned adjacent to the flange and being smaller than therelease liner opening, and a retaining portion positioned adjacent tothe middle portion and having a portion thereof larger than the releaseliner opening, for retaining the release liner on the middle portion.

Additional and/or other aspects and advantages of the present inventionwill be set forth in part in the description that follows and, in part,will be apparent from the description, or may be learned by practice ofthe invention.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and/or other aspects and advantages of embodiments of theinvention will be more readily appreciated from the following detaileddescription, taken in conjunction with the accompanying drawings, ofwhich:

FIG. 1 illustrates a perspective view of an embodiment of a patch-likeinfusion or self-injection device in a pre-activated state prior toactivation;

FIG. 2 illustrates a partially exploded view of the infusion device ofFIG. 1 in the pre-activated state;

FIG. 3 illustrates a partially exploded view of the infusion device ofFIG. 1 in the pre-activated state with an activator button rotated awayto reveal more detail;

FIG. 4 illustrates a more fully exploded view of the infusion device ofFIG. 1 in the pre-activated state;

FIG. 5 illustrates a cross-sectional view of the infusion device of FIG.1 in the pre-activated state;

FIG. 6 illustrates a cross-sectional view of the infusion device of FIG.1 in the pre-activated state with the activator button rotated away;

FIG. 7 illustrates a partially exploded view of the infusion device ofFIG. 1 during installation of a safety mechanism;

FIG. 8 illustrates a partially exploded view of the infusion device ofFIG. 1 subsequent to activation;

FIG. 9 illustrates a more fully exploded view of the infusion device ofFIG. 1 subsequent to activation;

FIG. 10 illustrates a cross-sectional view of the infusion device ofFIG. 1 subsequent to activation;

FIG. 11 illustrates a partially exploded view of the infusion device ofFIG. 1 subsequent to deployment of the safety mechanism;

FIG. 12 illustrates a cross-sectional view of the infusion device ofFIG. 1 subsequent to deployment of the safety mechanism;

FIG. 13 illustrates a bottom surface of the safety mechanism;

FIG. 14 further illustrates the structure of the safety mechanism;

FIGS. 15A-15D illustrate an end-of-dose indicator and the operationthereof in the infusion device of FIG. 1;

FIG. 16 illustrates an embodiment of an infusion device with aninjection port;

FIG. 17 illustrates an embodiment of an adhesive pad and adhesiverelease liner in the infusion device of FIG. 1;

FIG. 18 illustrates a needle-covering portion of a needle cover in theinfusion device of FIG. 1;

FIG. 19 illustrates an embodiment of a needle cover including theneedle-covering portion of FIG. 18;

FIGS. 20A to 20C illustrate an embodiment of a needle cover in theinfusion device of FIG. 1 including the needle-covering portion of FIG.18;

FIGS. 21A and 21B illustrate an embodiment of a needle cover in theinfusion device of FIG. 1 including the needle-covering portion of FIG.18;

FIGS. 22A-22D illustrate an embodiment of a needle cover in the infusiondevice of FIG. 1;

FIGS. 23A and 23B illustrate an embodiment of a needle cover in theinfusion device of FIG. 1;

FIG. 24 illustrates an embodiment of a needle cover in the infusiondevice of FIG. 1; and

FIGS. 25A and 25B illustrate an embodiment of a needle cover in theinfusion device of FIG. 1.

DETAILED DESCRIPTION OF EXEMPLARY EMODIMENTS

Reference will now be made in detail to embodiments of the presentinvention, examples of which are illustrated in the accompanyingdrawings, wherein like reference numerals refer to the like elementsthroughout. The embodiments described exemplify the present invention byreferring to the drawings.

The embodiments of the present invention described below can be used asa convenient, patch-like infusion or self-injection device 100 todeliver a pre-measured dose of a substance, such as a liquid drug ormedication, to a patient over a period of time or all at once. Thedevice is preferably provided to the end user in a pre-filled condition,that is, with the drug or medication already in the device reservoir.Though the patch-like infusion or self-injection device 100 (shown, forexample, in FIG. 1) described herein can be employed by a patient and/ora caregiver, for convenience, a user of the device is hereinafterreferred to as a “patient.” Additionally, for convenience, terms such as“vertical” and “horizontal” and “top” and “bottom” are employed torepresent relative directions with respect to an infusion device 100disposed on a horizontal surface. It will be understood, however, thatthe infusion device 100 is not limited to such an orientation, and thatthe infusion device 100 may be employed in any orientation. Further, thealternative use of the terms “infusion device” and “self-injectiondevice” to describe devices embodying the present invention is notintended in a limiting sense. Infusion devices that do not have aself-injection capability are within the scope of the present invention,as are self-injection devices that do not carry out continuous infusion.For convenience, but not by way of limitation, the term “infusiondevice” is used in the description that follows.

The patch-like infusion device 100 of FIG. 1 is self-contained and isattached to the skin surface of the patient by adhesive disposed on abottom surface of the infusion device 100 (as will be described ingreater detail below). Once properly positioned and activated by thepatient, the pressure of a released spring on a flexible reservoirwithin the device can be used to empty the contents of the reservoirthrough one or more patient needles (for example, microneedles) via aneedle manifold. The substance within the reservoir is then deliveredthrough the skin of the patient by the microneedles, which are driveninto the skin. It will be understood that other embodiments are possiblein which the spring is replaced with a different type of stored energydevice, which may be mechanical, electrical and/or chemical in nature.

As will be appreciated by one skilled in the art, there are numerousways of constructing and using the patch-like infusion device 100disclosed herein. Although reference will be made to the embodimentsdepicted in the drawings and the following descriptions, the embodimentsdisclosed herein are not meant to be exhaustive of the variousalternative designs and embodiments that are encompassed by thedisclosed invention. In each disclosed embodiment, the device isreferred to as an infusion device, but the device may also injectsubstances at a much faster (bolus) rate than is commonly accomplishedby typical infusion devices. For example, the contents can be deliveredin a period as short as several seconds or as long as several days.

In an embodiment of the device shown in FIGS. 1 through 12, apush-button design of the patch-like infusion device 100 is shownwherein the activation and energizing of the device is accomplished in asingle multi-function/step process. FIG. 1 illustrates an assembledembodiment of the infusion device 100 in a pre-activated state. FIGS.2-6 illustrate partially exploded and cross-sectional views of theinfusion device 100 in the pre-activated state, FIG. 7 illustrates apartially exploded view of the infusion device 100 during installationof a safety mechanism, FIGS. 8-10 illustrate exploded andcross-sectional views of the infusion device 100 subsequent toactivation, and FIGS. 11 and 12 illustrate exploded and cross-sectionalviews of the infusion device 100 subsequent to deployment of the safetymechanism. The infusion device 100 is configured to operate between thepre-activated state (shown, for example, in FIGS. 1, 2, and 5), anactivated or fired state (shown, for example, in FIGS. 8-10), and aretracted or safe state (shown, for example, in FIGS. 11 and 12).

As shown in FIG. 1, an embodiment of the patch-like infusion device 100includes a bottom enclosure 104, a safety mechanism 108, a flexibleneedle-covering portion 112 of a needle cover 114, a top enclosure 116,a reservoir subassembly 120, an end-of-dose indicator (EDI) 124, and anactivator button 128, which includes a patient interface surface 132.Additionally, as shown in FIGS. 2-6, the infusion device 100 alsoincludes a rotor or activation ring 136, a pressurization spring 140, adome-like metal plunger 144, and a drive spring 148.

The flexible needle-covering portion 112 provides patient and devicesafety by protecting at least one needle 152 (described in greaterdetail below) and providing a sterile barrier. The needle-coveringportion 112 protects the needle 152 during device manufacture, protectsthe patient prior to use, and provides a sterility barrier at any pointprior to removal. According to one embodiment, the needle-coveringportion 112 is attached via a press fit with a needle manifold in whichthe at least one needle 152 is disposed. Additionally, according to oneembodiment, a needle opening 156 (described in greater detail below) ofthe safety mechanism 108 is shaped to closely correspond to a perimeterof the needle-covering portion 112.

As shown, for example, in FIGS. 2, 3, 5, 6, 8, 10, and 12, the reservoirsubassembly 120 includes a reservoir 160, a reservoir dome seal 164, avalve 168, at least one needle 152, and at least one channel 172 (see,for example, FIG. 8) disposed between the valve 168 and the needle 152and creating a flow path therebetween. The reservoir 160 includes a dome176. Additionally, the reservoir subassembly 120 includes the removableneedle-covering portion 112 to selectively cover the at least one needle152. According to one embodiment, the reservoir subassembly 120 alsoincludes a reservoir arm seal 180, covering the channel 172. Preferably,the needle 152 includes a needle manifold and a plurality ofmicroneedles 152.

The reservoir dome seal (flexible film) 164 of the reservoir subassembly120, as shown, for example, in FIG. 5, is disposed between the plunger144 and the dome 176. Reservoir contents (for example, medicinalmaterial) for the infusion device 100 are disposed in the space betweenthe reservoir dome seal 164 and the dome 176. The combination of thereservoir dome seal 164, the dome 176, and the space therebetweendefines a reservoir 160. The dome 176 is preferably transparent topermit viewing of the reservoir contents. The reservoir dome seal 164can be made of non-distensible materials or laminates, such asmetal-coated films or other similar substances. For example, onepossible flexible laminate film that can be used in the reservoir domeseal 164 includes a first polyethylene layer, a second chemical layer asknown to those skilled in the art to provide an attachment mechanism fora third metal layer which is chosen based upon barrier characteristics,and a fourth layer that includes polyester and/or nylon. By utilizing ametal-coated or metallized film in conjunction with a rigid portion (forexample, dome 176), the barrier properties of the reservoir 160 areimproved, thereby increasing or improving the shelf life of the contentscontained within. For example, where a reservoir content includesinsulin, the primary materials of contact in the reservoir 160 includelinear, low-density polyethylene (LLDPE), low-density polyethylene(LDPE), cyclic olefin copolymer (COC) and Teflon. As described ingreater detail below, the primary materials of contact in the remainingflow path of the reservoir contents may also include COC and LLDPE, aswell as thermoplastic elastomer (TPE), medical grade acrylic, stainlesssteel, and a needle adhesive (e.g. a UV cured adhesive). Such materialsthat remain in extended contact with the contents of the reservoir 160preferably pass ISO 10-993 and other applicable biocompatibilitytesting.

The reservoir subassembly 120 is further preferably able to be storedfor the prescribed shelf life of the reservoir contents in applicablecontrolled environments without adverse effect to the contents, and iscapable of applications in a variety of environmental conditions.Additionally, the barrier provided by the components of the reservoirsubassembly 120 do not permit the transport of gas, liquid, and/or solidmaterials into or out of the contents at a rate greater than thatallowable to meet the desired shelf life. In the embodiments shownabove, the reservoir materials are capable of being stored and operatedin a temperature range of approximately 34 to 120 degrees Fahrenheit andcan have a shelf life of two or more years.

In addition to satisfying stability requirements, the reservoirsubassembly 120 can further ensure operation by successfully passing anynumber of leak tests, such as holding a 30 psi sample for 20 minuteswithout leaking. Additional filling, storage and delivery benefitsresulting from the configuration of the reservoir include minimizedheadspace and adaptability as described in greater detail below.

In one embodiment, the reservoir 160 is evacuated prior to filling. Byevacuating the reservoir 160 prior to filling and having only a slightdepression in the dome 176, headspace and excess waste within thereservoir 160 can be minimized. In addition, the shape of the reservoircan be configured to adapt to the type of energizing mechanism (forexample, pressurization spring 140 and plunger 144) used. Additionally,using an evacuated flexible reservoir 160 during filling minimizes anyair or bubbles within the filled reservoir 160. The use of a flexiblereservoir 160 is also very beneficial when the infusion device 100 issubjected to external pressure or temperature variations, which can leadto increased internal reservoir pressures. In such case, the flexiblereservoir 160 expands and contracts with the reservoir contents, therebypreventing possible leaks due to expansion and contraction forces.

Yet another feature of the reservoir 160 includes the ability to permitautomated particulate inspection at the time of filling, or by a patientat the time of use. One or more reservoir barriers, such as the dome176, can be molded of a transparent, clear plastic material, whichallows inspection of the substance contained within the reservoir. Thetransparent, clear plastic material is preferably a cyclic olefincopolymer that is characterized by high transparency and clarity, lowextractables, and biocompatibility with the substance contained in thereservoir 160. A suitable material is available from Zeon Chemicals,L.P., of Louisville, Ky. under the designation “BD CCP Resin,” and islisted by the U.S. Food and Drug Administration and DMF No. 16368. Insuch applications, the reservoir 160 includes minimal features thatcould possibly obstruct inspection (i.e. rotation during inspection ispermitted).

Channel arm 172 is provided in the form of at least one flexible arcuatearm extending from the valve 168 to the needle manifold or microneedles152. The arcuate arm has a groove 174 (see, for example, FIG. 2) formedtherein. To provide a fluid path between valve 168 and the needlemanifold or microneedles 152, the reservoir arm seal 180 covers thegroove 174. The fluid path (disposed in channel arm 172—shown, forexample, in FIG. 8) between the reservoir 160 and the microneedles 152is constructed of materials similar or identical to those describedabove for the reservoir 160. For example, channel arm 172 may beconstructed of the same material as the dome 160 and the reservoir armseal 180 may constructed of the same material as the reservoir dome seal164. According to one embodiment, both channel arms 172 are employed asfluid paths between the valve 168 and the needle manifold ormicroneedles 152. According to another embodiment, only one of thechannel arms 172 is employed as a fluid path, and the remaining channelarm 172 provides structural support. In such an embodiment, the groove174 extends fully from the valve 168 to the needle manifold ormicroneedles 152 only in the channel arm 172 that will be employed asthe fluid path.

The channel arm 172 must be sufficiently flexible to withstand the forceof activation. Contrasting the position of the channel arm 172 in FIGS.2 and 8, the channel arm 172 (covered by reservoir arm seal 180 in FIG.2, which is removed in FIG. 8 for clarity) elastically deforms when themicroneedles 152 are driven into the patient's skin (described ingreater detail below). During such deformation, the channel arm 172 mustmaintain the integrity of the fluid path between the valve 168 and theneedle manifold or microneedles 152. Additionally, the materials for thechannel arm 172 satisfy numerous biocompatibility and storage tests. Forexample, as shown in Table 1 below, where an infusion device contentincludes insulin, the primary materials of contact in the reservoir 160include linear, low-density polyethylene, cyclic olefin copolymer, andTeflon, and can also include a transparent, clear plastic. The primarymaterials of contact in the remaining flow path (channel 62) between thereservoir 160 and the microneedles 152 of the needle manifold includeCOC and/or medical grade acrylic, LLDPE, TPE, and stainless steel, aswell as the needle adhesive.

TABLE 1 Path Component Material Reservoir Polyethylene, cyclic olefincopolymer, and/or Teflon Reservoir Dome Seal Metal-coated film, such aspolyethylene, aluminum, polyester, and/or nylon with a chemical tielayer Valve TPE Needle Manifold COC and/or medical grade acrylic Needleadhesive UV-cured adhesive Microneedle Stainless steel

More specifically, the microneedles 152 can be constructed of stainlesssteel, and the needle manifold can be constructed of polyethylene and/ormedical grade acrylic. Such materials, when in extended contact with thecontents of the reservoir, preferably pass ISO 10-993 biocompatibilitytesting.

The valve 168, disposed between the reservoir 160 and the channel 172,selectively permits and restricts fluid flow between the reservoir 160and the channel 172. The valve 168 moves between a pre-activatedposition (shown, for example, in FIGS. 2, 3, and 6) and an activatedposition (shown, for example, in FIGS. 8-10). When in the activatedposition, the valve permits fluid flow between the reservoir 160 and thechannel 172, and therefore to the needle manifold and microneedles 152.

In use, the valve 168 will eventually be pushed into the activatedposition by the movement of the activator button 128, best illustratedby the movement of the valve 168 between FIGS. 5 and 10. As shown inFIG. 10, the movement of the valve 168 advances the enlarged distal endof the valve 168, thereby permitting the drug to flow from the reservoir160 into the channel 172 and down the fluid path to the needle manifold.

The embodiment described above includes at least one needle 152, ormicroneedle 152, but may contain several, such as the two illustratedmicroneedles 152. Each microneedle 152 is preferably at least 31 gaugeor smaller, such as 34 gauge, and is anchored within a patient needlemanifold that can be placed in fluid communication with the reservoir160. The microneedles 152, when more than one is included in theinfusion device 100, can also be of differing lengths, or gauges, or acombination of both differing lengths and gauges, and can contain one ormore ports along a body length, preferably located near the tip of themicroneedle 152 or near the tip bevel if any of the microneedles 152 hasone.

According to one embodiment, the gauge of the microneedles 152 governsthe delivery rate of reservoir contents of the infusion device 100. Theuse of multiple 34 gauge microneedles 152 to deliver the reservoircontents is practical when the infusion occurs over a longer period thantypically associated with an immediate syringe injection requiring amuch larger cannula, or needle. In the disclosed embodiments, anymicroneedles 152 that target either an intradermal or subcutaneous spacecan be used, but the illustrated embodiments include intradermalmicroneedles 152 of between 1 and 7 mm in length (i.e., 4 mm). Thearrangement of the microneedles 152 can be in a linear or nonlineararray, and can include any number of microneedles 152 as required by thespecific application.

As noted above, the microneedles 152 are positioned in a needlemanifold. In the needle manifold, at least one fluid communication path,or channel 172, is provided to each microneedle 152. The manifold maysimply have a single path to one or more microneedles 152, or mayprovide multiple fluid paths or channels routing the reservoir contentsto each microneedle 152 separately. These paths or channels may furthercomprise a tortuous path for the contents to travel, thereby affectingfluid pressures and rates of delivery, and acting as a flow restrictor.The channels or paths within the needle manifold can range in width,depth and configuration depending upon application, where channel widthsare typically between about 0.015 and 0.04 inch, preferably 0.02 inch,and are constructed to minimize dead space within the manifold.

According to one embodiment, the reservoir subassembly 120 has a pair ofholes 184 and 188 to aid registration of the reservoir subassembly 120with respect to the bottom enclosure 104. First and second posts 192 and196 (described in greater detail below) of the bottom enclosure 104 areinserted through the respective holes 184 and 188.

In exploded views with the reservoir subassembly 120 removed, FIGS. 4,7, and 9 illustrate that bottom enclosure 104 includes a substantiallycylindrical housing 200 in which pressurization spring 140 and plunger144 are disposed. According to one embodiment, cylindrical housing 200includes a plurality of recessed channels 204 to guide a respectiveplurality of legs 208 and feet 212 of the plunger 144 as the plungertranslates within the housing 200. Collectively, a leg 208 and a foot212 constitute a plunger tab 214. As shown in FIGS. 4, 7, and 9, forexample, the recessed channels 204 extend only part of the way down thecylindrical housing 200 from a top thereof. Below the recessed channels204, there are openings 216 through which the feet 212 of plunger 144can extend outside of the cylindrical housing 200. The openings 216 aresubstantially L-shaped with horizontal portions at the base of thecylindrical housing 200, and a vertical portion substantially alignedwith the recessed channels 204.

When the infusion device 100 is in the pre-activated state, thepressurization spring 140 is compressed by the plunger 144 (as shown,for example, in FIGS. 4-6), and the feet 212 of the plunger 144 aresubstantially disposed in the horizontal portions of the openings 216.The force of the pressurization spring 140 biases the feet 212 of theplunger 144 against a top of the horizontal portions of the openings 216(i.e., a ledge of the cylindrical housing 200). Together, as describedin greater detail below, the pressurization spring 140 and the plunger144 form a pressurization system to pressurize the reservoir 160 whenthe infusion device 100 is activated.

As described in greater detail below, the rotor 136 rotates around thebase of the cylindrical housing 200 between a pre-activated position(illustrated, for example, in FIGS. 2-4) and an activated position(illustrated, for example, in FIGS. 8-10). When the rotor 136 rotatesfrom the pre-activated position to the activated position, at least onefoot engaging surface 220 (shown, for example, in FIG. 4) of the rotor136 engages at least one of the feet 212 of the plunger 144 and rotatesthe plunger 144 so that the feet 212 align with the vertical portions ofthe openings 216 and the recessed channels 204. At this point, thepressurization spring 140 moves the plunger 144 upward with the feet 212being guided by the raised channels 204.

The pressurization spring 140 is included in the infusion device 100 toapply an essentially even force to the reservoir 160, to force thecontents from the reservoir 160. The pressurization spring 140 is usedto store energy that, when released, pressurizes the reservoir 160 atthe time of use. The pressurization spring 140 is held in a compressedstate by engagement between feet 212 of the plunger 144 and thecylindrical housing 200. This engagement prevents the pressurizationspring 140 from putting stress on a film (to be described later) of thereservoir 160 or any remaining device components (other than the bottomenclosure 104 and the plunger 144) during storage. The plunger 144 issufficiently rigid to resist spring tension and deformation, and shouldnot fail under normal load.

As noted above, when the rotor 136 rotates from the pre-activatedposition to the activated position, the rotor 136 engages at least oneof the feet 212 of the plunger 144 and rotates the plunger 144 to alignthe feet 212 with the vertical portions of the openings 216 and therecessed channels 204. The compressed pressurization spring 140, thenmoves the plunger 144 upward, and in doing so, exerts a force on thefilm of the reservoir 160. The pressurization spring 140 can beconfigured to preferably create a pressure within the reservoir 116 offrom about 1 to 50 psi, and more preferably from about 2 to about 25 psifor intradermal delivery of the reservoir contents. For sub-cutaneousinjection or infusion, a range of about 2 to 5 psi may be sufficient.

According to one embodiment, the activator button 128 includes thepatient interface surface 132 that the patient presses to activate theinfusion device 100. The activator button 128 also includes a hinge arm224 and an activation arm 228 (both shown, for example, in FIG. 3). Thehinge arm 224 of the activator button 128 includes a cylindrical portionwith an opening. The activation arm 228 includes a tab 230 (see, forexample, FIG. 3). According to one embodiment, the tab 230 includes abearing surface 232 and a locking surface 234 disposed adjacent to thecantilevered end of the bearing surface 232. According to oneembodiment, the tab 230 forms an acute angle with a main portion of theactivation arm 228.

The first post 192, disposed on the bottom enclosure 104, extendsupwardly therefrom. According to one embodiment (as shown, for example,in FIGS. 4 and 7), a base of the first post 192 includes a pair of flatsides 236 and a pair of rounded sides 240. Additionally, as shown, forexample, in FIGS. 4 and 7, the second post 196 and first and seconddrive spring bases 244 and 248 extend upwardly from the bottom enclosure104. As will be described in greater detail below, the first and seconddrive spring bases 244 and 248 anchor respective ends of drive spring148. The first drive spring base 244 is disposed adjacent to the secondpost 196 with a space therebetween.

According to one embodiment, FIGS. 3 and 6 illustrate the positioning ofthe activator button 128 with respect to the bottom enclosure 104, forassembly of the activator button 128. In this position, the opening ofthe cylindrical portion of the hinge arm 224 allows the activator button128 to slide horizontally (passing the flat sides 236) and engage thefirst post 192. The hinge arm 224 (and therefore the activator button128) can then rotate about the first post 192. As the activation arm 228passes into the space between the second post 196 and the first drivespring base 244, at least one of the tab 230 and the activation arm 228elastically deforms until a cantilevered end of the bearing surface 232of tab 230 passes a retaining face 252 of the second post 196. Thepassage of the cantilevered end of the bearing surface 232 of tab 230past the retaining face 252 (see, for example, FIG. 4) of the secondpost 196 and the engagement of the locking surface 234 of tab 230 withthe retaining face 252 provides an audible click and tactile feedbackconveying that the activator button 128 is in the pre-activatedposition.

Referring back to FIGS. 2-4, and 7-9, rotor 136 additionally includes anactivation projection 256 and a drive spring holder 260. The activationarm 228 of the activator button 128 engages the activation projection256 when a patient depresses the activator button 128, thereby rotatingthe rotor 136 from the pre-activated position to the activated position.

The drive spring holder 260 maintains the drive spring 148 in apre-activated position when the rotor 136 is in the pre-activatedposition. As noted previously, the first and second drive spring bases244 and 248 anchor opposing ends of the drive spring 148. Atapproximately a midpoint of the drive spring 148, there is asubstantially U-shaped projection as shown, for example, in FIGS. 2 and3, for engagement with the drive spring holder 260 of the rotor 136.Accordingly, when the rotor 136 is in the pre-activated position and thedrive spring 148 engages the drive spring holder 260, the drive spring148 is maintained in a tensile state. And when the drive spring holder260 releases the drive spring 148 (i.e., when the rotor rotates from thepre-activated position to the activated position as illustrated, forexample, in FIGS. 8-10), the drive spring 148 drives the microneedles152 to extend outside of the infusion device 100 through an opening 300in the bottom enclosure 104 (and through an opening in the safetymechanism 108 described in greater detail below).

Thus, as will be described in greater detail below, the activation andenergizing of the infusion device 100 that is accomplished in a singlemulti-function/step process includes depression of the activator button128 by a patient, and rotation of the rotor 136 due to engagementbetween the activation arm 228 of the activator button 128 and theactivation projection 256 of the rotor 136. As described above, therotation of the rotor 136 rotates and releases the plunger 144 topressurize the fluid within the reservoir 160. Additionally, therotation of the rotor 136 releases the drive spring 148 from the drivespring holder 260, thereby driving the microneedles 152 to extendoutside of the infusion device 100. The single multi-function/stepprocess also includes movement of the valve 168 from the pre-activatedposition to the activated position due to the activator button 128engaging and moving the valve 168 when the activator button 128 isdepressed, thereby commencing fluid flow between the reservoir and themicroneedles 152 via the channel 172.

As noted above, the patch-like infusion device 100 also includes asafety mechanism 108. To prevent inadvertent or accidental needle stickinjuries, prevent intentional re-use of the device, and to shieldexposed needles, the locking needle safety mechanism 108 is provided.The safety mechanism 108 automatically activates immediately uponremoval of the infusion device 100 from the skin surface of the patient.According to one embodiment described in greater detail below, aflexible adhesive pad 264 adheres to a bottom portion of the bottomenclosure 104 and a bottom portion of the safety mechanism 108. Theadhesive pad 264 contacts with the patient's skin and holds the infusiondevice 100 in position on the skin surface during use. As shown, forexample, in FIGS. 11 and 12, upon removal of the infusion device 100from the skin surface, the safety mechanism 108 extends to a positionshielding the microneedles 152. When fully extended, safety mechanism108 locks into place and prevents accidental injury or exposure to thepatient needles 152.

In general, a passive safety system is most desirable. This allows thedevice to be self-protecting in case of accidental removal or if thepatient forgets that there is a safety step. Because one typical use forthis infusion device 100 is to provide human growth hormone, which isusually given in the evening, it can be expected that patients that wearthe device (such as children) may actually wear them overnight, eventhough the delivery may be expected to take less than 10 minutes.Without a passive system, if the infusion device 100 falls off, themicroneedles 152 could re-stick the patient or a caregiver. The solutionis to either limit the activities during use, or include a passivesafety system.

With respect to safety systems, there are typically three options. Afirst option is to retract the needles 152 into the device. A secondoption is to shield the needles 152 to remove access, and a third optionis to destroy the needles 152 in a way that prevents needle stickinjuries. Other systems, such as active systems, utilize manualshielding and/or destruction, or manual release of safety features withan additional button push or similar action. A detailed description ofpassive safety embodiments of the present invention is provided below.

One safety embodiment of the present invention is a passive, fullyenclosed pull-out design embodiment, such as safety mechanism 108. FIGS.5, 10, and 12 are perspective cutaway views of the infusion device 100that illustrate the safety mechanism 108 prior to activation, subsequentto activation, and subsequent to deployment of the safety mechanism 108,respectively.

When the infusion device 100 is removed from the skin, the flexibleadhesive pad 264 (attached to both the bottom surface of the bottomenclosure 104 and the bottom surface of the safety mechanism 108) willpull the safety mechanism 108 out and lock it into place before theadhesive pad 264 releases the skin surface. In other words, the forcerequired to remove the adhesive pad from the skin surface is greaterthan that required to deploy the safety mechanism 108. According to oneembodiment, the safety mechanism 108, as shown, for example, in FIG. 13,includes a flat surface portion 268 that is in contact with thepatient's skin. The flat surface 268 is where a portion of adhesive pad264 (shown as a dotted line in FIG. 13) is affixed to safety mechanism108 such that when the infusion device 100 is removed by the patientfrom the skin, the adhesive pad 264 will act to deploy the safetymechanism 108 from the infusion device 100, thereby shielding themicroneedles 152, which otherwise would be exposed upon removal of theinfusion device 100 from the patient. When the safety mechanism 108 isfully extended, the safety mechanism 108 locks into place and preventsaccidental injury or exposure to the microneedles 152.

According to one embodiment, the adhesive pad 264 is provided insubstantially two parts, one on the bulk of the bottom surface of thebottom enclosure 104, and one on the bottom surface of the safetymechanism 108. When the infusion device 100 is removed, the two patchesmove independently and the safety mechanism 108 is rotatable withrespect to the bottom enclosure 104. According to another embodiment,the two parts are formed as a unitary, flexible adhesive pad 264 withone part being disposed on the on the bulk of the bottom surface of thebottom enclosure 104, and one part disposed on the bottom surface of thesafety mechanism 108.

According to one embodiment, the safety mechanism 108 is a stamped metalpart. According to another embodiment, the safety mechanism 108 is madeof substantially the same material as the bottom enclosure 104. As shownin FIG. 14, the safety mechanism 108 includes a front shield 272, a pairof insertion tabs 276 disposed at a rear portion of the safety mechanism108, a pair of pivot tabs 280 disposed, respectively, at upper rear endsof a rim portion 284 of the safety mechanism 108, a guide post 288extending upwardly from a substantially flat bottom inner surface of thesafety mechanism 108, and locking posts 292 also extending upwardly fromthe bottom inner surface of the safety mechanism 108. Front shield 272extends above the rim portion 284 to shield the patient from themicroneedles 152 when the safety mechanism 108 is deployed. The guidepost 288 includes a cutout therein to engage a safety retainingprojection 296 of the rotor 136 (shown, for example, in FIGS. 7 and 9)when the rotor 136 is in the pre-activated position, to prevent thesafety mechanism 108 from deploying prior to activation of the infusiondevice 100.

Additionally, as noted above, the safety mechanism 108 includes theneedle opening 156. Prior to deployment of the safety mechanism 108, theneedle opening 156 at least partially overlaps the opening 300 in bottomenclosure 104 to provide space for movement of the microneedles 152. Thelocking posts 292 are respectively disposed adjacent to front side edgesof the needle opening 156. The bottom enclosure 104 includes a guidepostopening 304 (shown, for example, in FIGS. 7 and 9), a pair of insertiontab openings 308 (one of which is shown, for example, in FIG. 4)disposed adjacent to opposing side edges of the bottom enclosure 104,and a pair of pivot rests 312 disposed on opposing sides of the bottomenclosure 104 (shown, for example, in FIGS. 7 and 9).

Referring again to FIG. 14, insertion tabs 276 each include a connectingportion 316 and an extending portion 320. According to one embodiment,the connecting portions 316 extend from the bottom inner surface of thesafety mechanism 108 toward a rear of the infusion device 100 at anon-perpendicular angle with respect to the bottom inner surface of thesafety mechanism 108. Extending portions 320 each extend substantiallyperpendicularly from the extending portions 320 toward respective outersides of the safety mechanism 108. To assemble the safety mechanism 108to the bottom enclosure 104, safety mechanism 108 is held at anapproximately 45° angle with respect to the bottom enclosure 104 and theinsertion tabs 276 are inserted through the insertion tab openings 308.The safety mechanism 108 is then rotated to a position such that theguidepost 288 is inserted through the guidepost opening 304 and thebottom inner surface of the safety mechanism 108 is substantiallyparallel and in contact with the bottom surface of the bottom enclosure104.

Referring again to FIGS. 7 and 9, although these views illustrate therotor 136 in the activated position, the exploded nature of FIGS. 7 and9 is convenient to illustrate this stage of the assembly of the safetymechanism 108 to the bottom enclosure 104. It will be understood,however, that the safety mechanism 108 should be assembled to the bottomenclosure prior to activation. Subsequent to the upward rotation of thesafety mechanism 108, as shown in FIG. 4, safety mechanism 108translates rearward with respect to the bottom enclosure 104 such thatpivot tabs 280 clear respective front edges of the pivot rests 312 andare disposed above the pivot rests 312, the locking posts 292 aredisposed adjacent to side edges of the opening 300 of the bottomenclosure 104, and the safety retaining projection 296 of the rotor 136engages the guide post 288.

Returning to FIG. 14, each of the locking posts 292 includes a postextending portion 324 extending substantially perpendicular from theflat bottom inner surface of the safety mechanism 108, and a wedgeportion 328 disposed at an end of the post extending portion 324. As aheight of the wedge portion 328 increases with respect to the bottominner surface of the safety mechanism 108, a width of the wedge portion328 increases.

As the safety mechanism 108 deploys and rotates downward with respect tothe bottom enclosure 104, the wedge portions 328 act against respectiveside edges of the openings 180 of the bottom enclosure 104, causing thelocking posts 192 to deform elastically toward one another. As thesafety mechanism 108 is fully deployed, the tabs 280 become seated inpivot rests 312. Additionally, top edges of the wedge portions 328 passbottom edges of the opening 300 and the locking posts 292 snap back totheir substantially un-deformed states, providing an audible click andtactile feedback communicating that the safety mechanism 108 is fullydeployed, and therefore, that the microneedles 152 are covered.Returning to FIGS. 11 and 12, once the safety mechanism 108 is fullydeployed and the locking posts 292 have snapped back to theirsubstantially un-deformed states, the top edges of the wedge portions328 engage the bottom surface of the bottom enclosure 104 adjacent tothe opening 300, thereby preventing the safety mechanism 108 fromrotating upward with respect to the bottom enclosure 104 and exposingthe microneedles 152. Additionally, as noted above, front shield 272shields the patient from the microneedles 152.

Accordingly, the safety mechanism 108 is a passive safety embodimentprovided as a single part and provides a good lock that will not crushunder human loads. With this passive safety mechanism, no additionalforces are applied to the skin during injection, and the microneedles152 are safely held within the infusion device 100 after use.

After use of the infusion device 100, the patient can once again inspectthe device to ensure the entire dose was delivered. In this regard, asshown in FIGS. 15A-D, the infusion device 100 includes the end-of-doseindicator (EDI) 124. The EDI 124 includes a main body 332 and first andsecond arms 336 and 340 extending substantially horizontally withrespect to a top of the main body 332.

The EDI 124 also includes a spring arm 344 that curves upwardly from thetop of the main body 332. According to one embodiment, the spring arm344 pushes against a bottom side of the reservoir subassembly 120,elastically biasing the EDI 124 toward the bottom enclosure 104, toensure that the EDI 124 does not move freely out of the infusion device100, for example, during shipping and handling of the infusion device100.

Returning to FIG. 4, the main body 332 is disposed in an EDI channel 348and translates substantially vertically therein. The EDI channeladjacent to one of the recessed channels 204 that guides legs 208 andfeet 212 of plunger 144. The first arm 336 extends across a top of thisrecessed channel 204.

Returning to FIG. 15A, a vertical extrusion 352 extends upwardly from anend of the second arm 340. When the reservoir contents have beendelivered, the vertical extrusion extends through an EDI opening 356(see, for example, FIG. 15C) in the top enclosure 116 to communicatethat the end of the dose has been reached. According to one embodiment,the EDI 124 is formed as a one-piece construction.

As shown in FIG. 15B, as the plunger 144 travels upwardly in thecylindrical housing 200 due to the pressurization spring 140 subsequentto activation, one of the feet 212 of the plunger 144 contacts the firstarm of the EDI 124. The foot 212 lifts the EDI 124 upward, overcomingthe bias of the spring arm 344, and causing the vertical extrusion 352to increasingly extend through the EDI opening 356 during delivery ofthe reservoir contents. Referring back to FIG. 10, vertical extrusion352 partially extends from the infusion device 100. Once the delivery ofthe reservoir contents is complete and the plunger has achieved its fullstroke, the vertical extrusion 352 is fully extended, as shown in FIG.15D. Thus, the EDI 124 employs the linear movement of the plunger 144 togenerate linear movement of the EDI 124 that is visible outside of theinfusion device 100 thereby communicating the delivery of the reservoircontents.

FIG. 16 illustrates an embodiment of an infusion device 400 with aninjection port 404. The injection port provides access to an evacuatedor partially-filled reservoir 408, so that the patient can inject asubstance or combination of substances into the reservoir prior toactivation. Alternatively, a pharmaceutical manufacturer or pharmacistcould employ the injection port 404 to fill the infusion device 400 witha substance or combination of substances prior to sale. In substantiallyall other respects, the infusion device 400 is similar to thepreviously-described infusion device 100.

Operation of the infusion device 100 will now be described. Theembodiments of the present invention described above preferably includea push-button (activator button 128) design wherein the infusion device100 can be positioned and affixed to a skin surface, and energizedand/or activated by pressing the activator button 128. Morespecifically, in a first step, the patient removes the device from asterile packaging (not shown), and removes a release liner (discussed ingreater detail below) of the adhesive pad 264. The patient also removesthe needle cover 114 (also discussed in greater detail below). Uponremoval of the infusion device 100 from the package and prior to use(see, for example, FIGS. 1, 2, 4, and 5), the infusion device 100 in thepre-activated state allows the patient to inspect both the device andthe contents therein, including inspection for missing or damagedcomponents, expiration dates(s), hazy or color-shifted drugs, and soforth.

The next step is the positioning and application of the infusion device100 to the patient's skin surface. Like a medicinal patch, the patientfirmly presses the infusion device 100 onto the skin. One side of theadhesive pad 264 adheres to a bottom surface of the bottom enclosure 104and a bottom surface of the safety mechanism 108, and the opposing sideof the adhesive pad 264 secures the infusion device 100 to the skin ofthe patient. In an alternative embodiment, the adhesive pad 264 may bereplaced by an adhesive applied directly to the bottom surface of thebottom enclosure 104 and the bottom surface of the safety mechanism 108.Such an adhesive would be covered by the release liner prior to use ofthe infusion device 100. These bottom surfaces (of the bottom enclosure104 and the safety mechanism 108) can be flat, contoured, or shaped inany suitable fashion and the adhesive pad 264 is secured thereon. Asdiscussed in greater detail below, according to one embodiment, prior toshipping, the release liner, such as a film, is applied to thepatient-side of the adhesive pad 264 to preserve the adhesive duringshipping. As noted above, prior to use, the patient peels back therelease liner, thereby exposing the adhesive pad 264 (or adhesive) forplacement against the skin.

After removing the release liner, the patient is able to place theinfusion device 100 against the skin and press to ensure properadhesion. As noted above, once properly positioned, the device isactivated by depressing the activator button 128. This activation stepreleases plunger 144 and the pressurization spring 140, allowing aplunger 144 to press against the flexible film (reservoir dome seal 164)of the reservoir 160, thereby pressurizing the reservoir. Thisactivation step also serves to release the drive spring 148 from thedrive spring holder 260 of the rotor 136, thereby driving themicroneedles 152 to extend outside the infusion device 100 (through theopening 300 in the bottom enclosure 104 and the needle opening 156 ofthe safety mechanism 108) and seat the microneedles 152 within thepatient. Further, the activation step opens the valve 168, establishinga fluid communication path between the reservoir 160 and themicroneedles 152, via the channel 172 (see, for example, FIGS. 8-10). Asignificant benefit derives from the ability to achieve each of theseactions in a single push-button operation. Additionally, anothersignificant benefit includes the use of a continuous fluid communicationpath comprised entirely within the reservoir subassembly 120.

Once activated, the patient typically leaves the infusion device 100 inposition, or wears the device, for some period of time (such as tenminutes to seventy-two hours) for complete delivery of the reservoircontents. The patient then removes and discards the device with nodamage to the underlying skin or tissue. Upon intentional or accidentalremoval, one or more safety features deploy to shield the exposedmicroneedles 152. More specifically, when the infusion device 100 isremoved by the patient from the skin, the adhesive pad 264 acts todeploy the safety mechanism 108 from the infusion device 100, therebyshielding the microneedles 152, which otherwise would be exposed uponremoval of the infusion device 100 from the patient. When the safetymechanism 108 is fully extended, the safety mechanism 108 locks intoplace and prevents accidental injury or exposure to the microneedles152. The safety features, however, can be configured to not deploy ifthe activator button 128 has not been depressed and the microneedles 152have not been extended, thereby preventing pre-use safety mechanismdeployment. After use, the patient can once again inspect the device toensure the entire dose was delivered. For example, the patient can viewthe reservoir interior through the transparent dome 176 and/or inspectthe EDI 124.

The described embodiments are suitable for use in administering varioussubstances, including medications and pharmaceutical agents, to apatient, and particularly to a human patient. As used herein, apharmaceutical agent includes a substance having biological activitythat can be delivered through the body membranes and surfaces, andparticularly the skin. Examples, listed in greater detail below, includeantibiotics, antiviral agents, analgesics, anesthetics, anorexics,antiarthritics, antidepressants, antihistamines, anti-inflammatoryagents, antineoplastic agents, vaccines, including DNA vaccines, and thelike. Other substances that can be delivered intradermally orsubcutaneously to a patient include human growth hormone, insulin,proteins, peptides and fragments thereof. The proteins and peptides canbe naturally occurring, synthesized or recombinantly produced.Additionally, the device can be used in cell therapy, as duringintradermal infusion of dendritic cells. Still other substances whichcan be delivered in accordance with the method of the present inventioncan be selected from the group consisting of drugs, vaccines and thelike used in the prevention, diagnosis, alleviation, treatment, or cureof disease, with the drugs including Alpha-1 anti-trypsin,Anti-Angiogenesis agents, Antisense, butorphanol, Calcitonin andanalogs, Ceredase, COX-II inhibitors, dermatological agents,dihydroergotamine, Dopamine agonists and antagonists, Enkephalins andother opioid peptides, Epidermal growth factors, Erythropoietin andanalogs, Follicle stimulating hormone, G-CSF, Glucagon, GM-CSF,granisetron, Growth hormone and analogs (including growth hormonereleasing hormone), Growth hormone antagonists, Hirudin and Hirudinanalogs such as hirulog, IgE suppressors, Insulin, insulinotropin andanalogs, Insulin-like growth factors, Interferons, Interleukins,Leutenizing hormone, Leutenizing hormone releasing hormone and analogs,Low molecular weight heparin, M-CSF, metoclopramide, Midazolam,Monoclonal antibodies, Narcotic analgesics, nicotine, Non-steroidanti-inflammatory agents, Oligosaccharides, ondansetron, Parathyroidhormone and analogs, Parathyroid hormone antagonists, Prostaglandinantagonists, Prostaglandins, Recombinant soluble receptors, scopolamine,Serotonin agonists and antagonists, Sildenafil, Terbutaline,Thrombolytics, Tissue plasminogen activators, TNF-, and TNF-antagonist,the vaccines, with or without carriers/adjuvants, includingprophylactics and therapeutic antigens (including but not limited tosubunit protein, peptide and polysaccharide, polysaccharide conjugates,toxoids, genetic based vaccines, live attenuated, reassortant,inactivated, whole cells, viral and bacterial vectors) in connectionwith, addiction, arthritis, cholera, cocaine addiction, diphtheria,tetanus, HIB, Lyme disease, meningococcus, measles, mumps, rubella,varicella, yellow fever, Respiratory syncytial virus, tick borneJapanese encephalitis, pneumococcus, streptococcus, typhoid, influenza,hepatitis, including hepatitis A, B, C and E, otitis media, rabies,polio, HIV, parainfluenza, rotavirus, Epstein Barr Virus, CMV,chlamydia, non-typeable haemophilus, moraxella catarrhalis, humanpapilloma virus, tuberculosis including BCG, gonorrhoea, asthma,atheroschlerosis malaria, E-coli, Alzheimers, H. Pylori, salmonella,diabetes, cancer, herpes simplex, human papilloma and the like othersubstances including all of the major therapeutics such as agents forthe common cold, Anti-addiction, anti-allergy, anti-emetics,anti-obesity, antiosteoporeteic, anti-infectives, analgesics,anesthetics, anorexics, antiarthritics, antiasthmatic agents,anticonvulsants, anti-depressants, antidiabetic agents, antihistamines,anti-inflammatory agents, antimigraine preparations, antimotion sicknesspreparations, antinauseants, antineoplastics, antiparkinsonism drugs,antipruritics, antipsychotics, antipyretics, anticholinergics,benzodiazepine antagonists, vasodilators, including general, coronary,peripheral and cerebral, bone stimulating agents, central nervous systemstimulants, hormones, hypnotics, immunosuppressives, muscle relaxants,parasympatholytics, parasympathomimetrics, prostaglandins, proteins,peptides, polypeptides and other macromolecules, psychostimulants,sedatives, sexual hypofunction and tranquilizers and major diagnosticssuch as tuberculin and other hypersensitivity agents as described inU.S. Pat. No. 6,569,143, entitled “Method of Intradermally InjectingSubstances”, the entire content of which is expressly incorporatedherein by reference.

Vaccine formulations which can be delivered in accordance with thesystem and method of the present invention can be selected from thegroup consisting of an antigen or antigenic composition capable ofeliciting an immune response against a human pathogen, which antigen orantigenic composition is derived from HIV-1, (such as tat, nef, gp120 orgp160), human herpes viruses (HSV), such as gD or derivatives thereof orImmediate Early protein such as ICP27 from HSVI or HSV2, cytomegalovirus(CMV (esp Human) (such as gB or derivatives thereof), Rotavirus(including live-attenuated viruses), Epstein Barr virus (such as gp350or derivatives thereof), Varicella Zoster Virus (VZV, such as gpl, IIand 1E63) or from a hepatitis virus such as hepatitis B virus (forexample Hepatitis B Surface antigen or a derivative thereof), hepatitisA virus (HAV), hepatitis C virus and hepatitis E virus, or from otherviral pathogens, such as paramyxoviruses: Respiratory Syncytial virus(RSV, such as F and G proteins or derivatives thereof), parainfluenzavirus, measles virus, mumps virus, human papilloma viruses (HPV forexample HPV6, 11, 16, 18), flaviviruses (e. g. Yellow Fever Virus,Dengue Virus, Tick-borne encephalitis virus, Japanese EncephalitisVirus) or Influenza virus (whole live or inactivated virus, splitinfluenza virus, grown in eggs or MDCK cells, or whole flu virosomes orpurified or recombinant proteins thereof, such as HA, NP, NA, or Mproteins, or combinations thereof), or derived from bacterial pathogenssuch as Neisseria spp, including N. gonorrhea and N. meningitidis (forexample capsular polysaccharides and conjugates thereof,transferrin-binding proteins, lactoferrin binding proteins, PilC,adhesins); S. pyogenes (for example M proteins or fragments thereof, C5Aprotease, lipoteichoic acids), S. agalactiae, S. mutans; H. ducreyi;Moraxella spp, including M catarrhalis, also known as Branhamellacatarrhalis (for example high and low molecular weight adhesins andinvasins); Bordetella spp, including B. pertussis (for examplepertactin, pertussis toxin or derivatives thereof, filamenteoushemagglutinin, adenylate cyclase, fimbriae), B. parapertussis and B.bronchiseptica; Mycobacterium spp., including M. tuberculosis (forexample ESAT6, Antigen 85A, -B or-C), M. bovis, M. leprae, M. avium, M.paratuberculosis M. smegmatis; Legionella spp, including L. pneumophila;Escherichia spp, including enterotoxic E. coli (for example colonizationfactors, heat-labile toxin or derivatives thereof, heat-stable toxin orderivatives thereof), enterohemorragic E. coli, enteropathogenic E. coli(for example shiga toxin-like toxin or derivatives thereof); Vibrio spp,including V. cholera (for example cholera toxin or derivatives thereof);Shigella spp, including S. sonnei, S. dysenteriae, S. flexnerii;Yersinia spp, including Y. enterocolitica (for example a Yop protein),Y. pestis, Y. pseudotuberculosis; Campylobacter spp, including C. jejuni(for example toxins, adhesins and invasins) and C. coli; Salmonella spp,including S. typhi, S. paratyphi, S. choleraesuis, S. enteritidis;Listeria spp., including L. monocytogenes; Helicobacter spp, includingH. pylori (for example urease, catalase, vacuolating toxin); Pseudomonasspp, including P. aeruginosa; Staphylococcus spp., including S. aureus,S. Epidermidis; Enterococcus spp, including E. faecalis, E. faecium;Clostridium spp., including C. tetani (for example tetanus toxin andderivative thereof), C. botulinum (for example Botulinum toxin andderivative thereof), C. difficile (for example clostridium toxins A or Band derivatives thereof); Bacillus spp., including B. anthracis (forexample botulinum toxin and derivatives thereof); Corynebacterium spp.,including C. diphtheriae (for example diphtheria toxin and derivativesthereof); Borrelia spp., including B. Burgdorferi (for example OspA,OspC, DbpA, DbpB), B. garinii (for example OspA, OspC, DbpA, DbpB), B.afzelii (for example OspA, OspC, DbpA, DbpB), B. andersonii (for exampleOspA, OspC, DbpA, DbpB), B. Hermsii; Ehrlichia spp., including E. equiand the agent of the Human Granulocytic Ehrlichiosis; Rickettsia spp,including R. rickettsii; Chlamydia spp., including C. Trachomatis (forexample MOMP, heparin-binding proteins), C. pneumoniae (for exampleMOMP, heparin-binding proteins), C. psittaci; Leptospira spp., includingL. interrogans; Treponema spp., including T. pallidum (for example therare outer membrane proteins), T. denticola, T. hyodysenteriae; orderived from parasites such as Plasmodium spp., including P. Falciparum;Toxoplasma spp., including T. gondii (for example SAG2, SAG3, Tg34);Entamoeba spp., including E. histolytica; Babesia spp., including B.microti; Trypanosoma spp., including T. cruzi; Giardia spp., includingG. lamblia; Leshmania spp., including L. major; Pneumocystis spp.,including P. Carinii; Trichomonas spp., including T. vaginalis;Schisostoma spp., including S. mansoni, or derived from yeast such asCandida spp., including C. albicans; Cryptococcus spp., including C.neoformans, as described in PCT Patent Publication No. WO 02/083214,entitled “Vaccine Delivery System”, the entire content of which isexpressly incorporated herein by reference.

These also include other preferred specific antigens for M.tuberculosis, for example Tb Ra12, Tb H9, Tb Ra35, Tb38-1, Erd 14, DPV,MTI, MSL, mTTC2 and hTCC1. Proteins for M. tuberculosis also includefusion proteins and variants thereof where at least two, preferablythree polypeptides of M. tuberculosis are fused into a larger protein.Preferred fusions include Ra12-TbH9-Ra35, Erd14-DPV-MTI, DPV-MTI-MSL,Erd14-DPV-MTI-MSL-mTCC2, Erd14-DPV-MTI-MSL, DPV-MTI-MSL-mTCC2,TbH9-DPV-MTI. Most preferred antigens for Chlamydia include for examplethe High Molecular Weight Protein (HWMP), ORF3, and putative membraneproteins (Pmps). Preferred bacterial vaccines comprise antigens derivedfrom Streptococcus spp, including S. pneumoniae (for example capsularpolysaccharides and conjugates thereof, PsaA, PspA, streptolysin,choline-binding proteins) and the protein antigen Pneumolysin (BiochemBiophys Acta, 1989,67,1007; Rubins et al., Microbial Pathogenesis,25,337-342), and mutant detoxified derivatives thereof. Other preferredbacterial vaccines comprise antigens derived from Haemophilus spp.,including H. influenzae type B (“Hib”, for example PRP and conjugatesthereof), non typeable H. influenzae, for example OMP26, high molecularweight adhesins, P5, P6, protein D and lipoprotein D, and fimbrin andfimbrin derived peptides or multiple copy variants or fusion proteinsthereof. Derivatives of Hepatitis B Surface antigen are well known inthe art and include, inter alia, PreS 1, PreS2 S antigens. In onepreferred aspect the vaccine formulation of the invention comprises theHIV-1 antigen, gp120, especially when expressed in CHO cells. In afurther embodiment, the vaccine formulation of the invention comprisesgD2t as hereinabove defined.

In addition to the delivery of substances listed above, the infusiondevice 100 can also be used for withdrawing a substance from a patient,or monitoring a level of a substance in the patient. Examples ofsubstances that can be monitored or withdrawn include blood,interstitial fluid or plasma. The withdrawn substances can then beanalyzed for analytes, glucose, drugs, and the like.

As noted above, according to one embodiment, the infusion device 100includes a needle cover 114 and a release liner for the adhesive pad264. Both the needle cover 114 and the release liner are removed priorto use of the infusion device 100. Additionally, the needle cover 114and the release liner are disposed of subsequent to removal from theinfusion device 100. One solution is to combine the needle cover and therelease liner such that removal of the needle cover also removes therelease liner. Another solution is to combine the needle cover and therelease liner such that removal of the release liner also removes theneedle cover. Optionally, the needle cover and the release liner canalso be disposed of simultaneously.

FIG. 17 illustrates an embodiment of the adhesive pad 264 and anadhesive release liner 500 of the infusion device 100, and FIG. 18illustrates the needle-covering portion 112 of the needle cover 114.Additionally, FIG. 19 illustrates an embodiment of a combination of aneedle cover 114A (including the needle-covering portion 112) and therelease liner 500. As shown in FIG. 17, adhesive pad 164 includes aneedle cover opening 504, and release liner 500 includes a liner opening508. FIG. 18 illustrates that needle-covering portion 112 includes aneyelet 512 with an eyelet opening 516, and a shoulder or flange 520. Asnoted previously, according to one embodiment, the needle-coveringportion 112 is attached to the needle manifold via a press fit. ThoughFIGS. 17 and 18 are not to the same scale, liner opening 508 is largerthan eyelet 512 but smaller than flange 520, and thus, eyelet 512 can beinserted through liner opening 508 such that the flange 520 contacts therelease liner 500. Additionally, needle cover opening 504 is larger thanthe cross section of needle-covering portion 112, such that the entireneedle-covering portion 112 can be inserted through needle cover opening504.

As shown in FIG. 19, needle cover 114A includes both needle-coveringportion 112 and a retaining portion or pull tab portion 524. The pulltab portion 524 includes a pull tab arm 528 that is insertable into theeyelet opening 516. FIG. 19 illustrates that after the eyelet 512 hasbeen inserted through the liner opening 508, once the pull tab arm 528is inserted into the eyelet opening 516, the pull tab portion 524retains the release liner 500 on the needle cover 114A. According to oneembodiment, at least one of the eyelet 512 and the pull tab portion 524is sufficiently flexible such that subsequent to the insertion of thepull tab arm 528 into the eyelet opening 516, the pull tab portion 524can be rotated approximately 90° from the position illustrated in FIG.19, for example, to minimize an external size or profile of the infusiondevice 100 for packaging. Additionally, though the pull tab portion 524can be rotated either forward or backward, rotation of the pull tabportion 524 toward the activator button 128 (similar to the embodimentillustrated in FIG. 20B) more effectively reduces the external profileof the infusion device 100.

To install the embodiment illustrated in FIG. 19, the needle-coveringportion 112 is inserted through the needle opening 156 and attached tothe needle manifold via a press fit, such that eyelet 512 extendsoutside of the infusion device 100. Subsequently, the adhesive pad 264is adhered to the bottom enclosure 104 and the safety mechanism 108 suchthat needle cover opening 504 of the adhesive pad 264 correspondssubstantially to the needle opening 156. Additionally, the release liner500 is adhered to the adhesive pad 264 such that the eyelet 512 isinserted through the liner opening 508 and the release liner 500contacts the flange 520. It will be understood that the adhesive pad 264and the release liner 500 may be applied in a single operation. Next,the pull tab arm 528 is inserted through the eyelet opening 516, therebysecuring the release liner 500, and combining the release liner 500 andthe needle cover 114A.

To remove the release liner 500 and the needle cover 114A, the patientgrasps and pulls the pull tab portion 524. Because the release liner 500is retained between the pull tab portion 524 and the flange 520, such asingle action by the patient not only removes the needle cover 114 fromthe needle manifold, but also removes the release liner 500 from theadhesive pad 264. Additionally, because the release liner 500 remainsretained between the pull tab portion 524 and the flange 520 subsequentto removal from the infusion device 100, the patient can easily disposeof the combined release liner 500 and needle cover 114A.

Similar to the embodiment of FIG. 19, FIGS. 20A-20C illustrates anembodiment of a needle cover 114B. In this embodiment, as shown in FIG.20A, the pull tab portion 532 and has a pull tab arm 536 that isinserted into the eyelet opening 516 of the eyelet 512 subsequent toinstallation of the adhesive pad 264 and the release liner 500. Incontrast to the embodiment of FIG. 19, however, the pull tab portion 532is substantially planar. As shown in FIG. 20B, such a planarconfiguration provides for a further-reduced profile in comparison tothe embodiment of FIG. 19, thereby requiring a smaller envelope forpackaging. Additionally, during assembly, the configuration of the pulltab portion 532 as shown in FIG. 20B may reduce side stresses to theneedle cover 114B that may contribute to compromising a seal between theneedle-covering portion 112 and the needle manifold.

Further, according to one embodiment, the pull tab arm 536 includesindexing to help align the pull tab portion 532 in a first positionsubstantially aligned with the needle-covering portion 112 and a secondposition substantially parallel to a bottom surface of the bottomenclosure 104. FIG. 20C illustrates the combined release liner 500 andneedle cover 114B subsequent to removal from the infusion device 100 andready for disposal.

FIGS. 21A and 21B illustrate another embodiment of a needle cover 114Cand a release liner 560. The release liner 560 includes a pull tab 564.Additionally, the needle cover 114C includes the needle-covering portion112 and a snap clip portion 568. The snap clip portion 568 includes apair of cantilevered snap clip wings 572. Each of the snap clip wings572 is elastically deformable and has a sloped face, such that as thesnap clip portion 568 is inserted into the eyelet opening 516, thesloped faces engage the eyelet 512 and the contact therebetweenprogressively deforms the snap clip wings 572. After trailing edges ofthe sloped faces pass through the eyelet opening 516, the snap clipwings 572 substantially return to their respective undeformed positions,thereby locking the snap clip portion 568 in the eyelet 512, andretaining the release liner 560 between the snap clip portion 568 andthe flange 520.

To remove the combined release liner 560 and needle cover 114C, thepatient grasps and pulls the pull tab 564 of the release liner 560.Because the release liner 560 is retained between the snap clip portion568 and the flange 520, such a single action removes both the releaseliner 560 and the needle cover 114C from the infusion device 100. FIG.21B illustrates the combined release liner 560 and needle cover 114Csubsequent to removal from the infusion device 100 and ready fordisposal.

In contrast to FIGS. 18, 19,20A-20C, 21A and 21B, in each of the needlecovers illustrated in FIGS. 22A-22D, 23A, 23B, 24, 25A, and 25B, aneedle-covering portion and a pull tab portion are integrally formed asa unitary structure. For example, FIGS. 22A-22D illustrate a needlecover 114D that includes a needle-covering portion 112D and a pull tabportion 580 that are connected by a living hinge, and are thus,integrally formed as a unitary structure. A living hinge can be providedas a thin flexible portion of plastic joining two more rigid plasticparts together, allowing the more rigid portions to rotate with respectto each other along, such that the living hinge is an axis of rotation.In other words, the thin web of the living hinge provides for rotationbetween the members connected by the living hinge. As shown, for examplein FIGS. 22B and 22C, the living hinge permits the pull tab portion 580to move between a first position substantially aligned with theneedle-covering portion 112D (FIG. 22B) and a second position (FIG. 22C)approximately 90° from the first position. In the second position, theneedle cover 114D provide a smaller profile and permits a smallerenvelope for packaging. Additionally, because of the smaller profile andconfiguration in the second position, the needle cover 114D is lesslikely to receive accidental impacts during assembly, and thus reducesside stresses to the needle cover 114D that may contribute tocompromising a seal between the needle-covering portion 112D and theneedle manifold.

As shown in FIG. 22A, the pull tab portion 580 includes a pair ofcantilevered pull tab wings 584. Each of the pull tab wings 584 iselastically deformable and has a sloped face, such that as the pull tabportion 580 is inserted into the liner opening 508, the sloped facesengage the release liner 500 and the contact therebetween progressivelydeforms the pull tab wings 584. After trailing edges of the sloped facespass through the liner opening 508, the pull tab wings 584 substantiallyreturn to their respective undeformed positions, thereby locking therelease liner onto the needle cover 114D, and retaining the releaseliner 500 between the pull tab wings 584 and the flange 520D (see, forexample, FIGS. 22A and 22D).

To remove the combined release liner 500 and needle cover 114D, thepatient rotates the pull tab portion 580 from the second position to thefirst position such that the pull tab portion 580 is substantiallyaligned with the needle-covering portion 112D. Then, the patient graspsand pulls the pull tab portion 580. Because the release liner 500 isretained between the pull tab wings 584 and the flange 520D, such asingle action removes both the release liner 500 and the needle cover114D from the infusion device 100. FIG. 22A illustrates the combinedrelease liner 500 and needle cover 114D during removal from the infusiondevice 100. Subsequently, the combined release liner 500 and the needlecover 114D are ready for disposal.

FIGS. 23A and 23B and illustrate yet another embodiment of a needlecover 114E that is combinable with the release liner 500. The needlecover 114E includes a needle-covering portion 112E and a pull tabportion 588, which includes a pair of pull tab hooks 592. At least oneof the release liner 500 and the pair of pull tab hooks 592 issufficiently elastically deformable that the pull tab hooks 592 areinsertable through the liner opening 508. Subsequent to such aninsertion, the release liner 500 is retained on the needle cover 114Ebetween the flange 520E and the pull tab hooks 592.

In addition to the flange 520E, the needle-covering portion 112E alsoincludes a post 596 extending therefrom, which has a post hook 600, asshown in FIG. 23A. Corresponding to the post 596, the pull tab portion588 includes a slot 604. According to one embodiment, the needle cover114E is integrally formed as a unitary structure, and the pull tabportion 588 is connected to the needle-covering portion 112E by a livinghinge.

When the pull tab portion 588 is rotated from a first position (FIG.23A) substantially aligned with a main or longitudinal axis of theneedle-covering portion 112E to a second position (FIG. 23B)approximately 90° from the first position, the post hook 600 engages anedge of the slot 600 for to maintain or lock the pull tab portion 588and the second position. When installed on the infusion device 100, thepull tab portion 588 of the needle cover 114E being configured in thesecond position provides a small profile, and thus allows for a smallenvelope for packaging the infusion device 100. Additionally, duringassembly, the needle cover 114E being configured in the second positionmay reduce side stresses to the needle cover 114E that may contribute tocompromising a seal between the needle-covering portion 112E and theneedle manifold.

To remove the combined release liner 500 and needle cover 114E from theinfusion device 100, the patient first applies sufficient force todisengage the edge of the slot 604 from the post hook 600 and rotatesthe pull tab portion 588 from the second position to the first positionsuch that the pull tab portion 588 is substantially aligned with theneedle-covering portion 112E. Then, the patient grasps and pulls thepull tab portion 588. Because the release liner 500 is retained betweenthe pull tab hooks 592 and the flange 520E, such a single action removesboth the release liner 500 and the needle cover 114E from the infusiondevice 100. Subsequently, the combined release liner 500 and the needlecover 114E are ready for disposal.

FIG. 24 illustrates still yet another embodiment of a needle cover 114Fthat is combinable with the release liner 500. The needle cover 114Fincludes a needle-covering portion 112F and a pull tab portion 608,which includes a pair of pull tab hooks 612. At least one of the releaseliner 500 and the pair of pull tab hooks 612 is sufficiently elasticallydeformable that the pull tab hooks 612 are insertable through the lineropening 508. Subsequent to such an insertion, the release liner 500 isretained on the needle cover 114F between the flange 520F and the pulltab hooks 612.

According to one embodiment, the needle cover 114F is integrally formedas a unitary structure. As shown in FIG. 24, a main or longitudinal axisof the pull tab portion 608 forms an approximately 90° angle withrespect to a main or longitudinal axis of the needle-covering portion112F.

When installed on the infusion device 100, the needle cover 114F withthe pull tab portion 608 provides a small profile, and thus allows for asmall envelope for packaging the infusion device 100. Additionally,during assembly, the configuration of the needle cover 114F may reduceside stresses to the needle cover 114F that may contribute tocompromising a seal between the needle-covering portion 112F and theneedle manifold.

To remove the combined release liner 500 and needle cover 114F from theinfusion device 100, the patient the patient grasps and pulls the pulltab portion 608. Because the release liner 500 is retained between thepull tab hooks 612 and the flange 520F, such a single action removesboth the release liner 500 and the needle cover 114F from the infusiondevice 100. Subsequently, the combined release liner 500 and the needlecover 114F are ready for disposal.

FIGS. 25A and 25B illustrate another embodiment of a needle cover 114Gthat is combinable with the release liner 500. As shown in FIGS. 25A and25B, the needle cover 114G includes a needle-covering portion 112G and apull tab portion 616, which includes a pair of pull tab hooks 620. Atleast one of the release liner 500 and the pair of pull tab hooks 620 issufficiently elastically deformable that the pull tab hooks 612 areinsertable through the liner opening 508. Subsequent to such aninsertion, the release liner 500 is retained on the needle cover 114Gbetween a flange 520G of the needle-covering portion 112G and the pulltab hooks 620.

According to one embodiment, the needle cover 114G is integrally formedas a unitary structure, and the pull tab portion 588 is connected to theneedle-covering portion 112G by a living hinge, which is incorporatedinto a bi-stable hinge. A bi-stable hinge, such as can be found, forexample, on shampoo or cosmetic bottle lids, remains stable in twopositions. For example, the two stable positions of the needle cover114G are a first position (FIG. 25A) substantially aligned with a mainor longitudinal axis of the needle-covering portion 112G and a secondposition (FIG. 25B) approximately 90° from the first position. In thebi-stable hinge of the needle cover 114G, a thin web of material actslike a spring to bias the pull tab portion 616 toward both the first andsecond positions. For example, during rotation from the first positiontoward the second position, the bi-stable hinge biases the pull tabportion 616 toward the first position until a tipping point is reached,at which point the bi-stable hinge biases the pull tab portion 616toward the second position.

When installed on the infusion device 100, the pull tab portion 616 ofthe needle cover 114G being configured in the second position provides asmall profile, and thus allows for a small envelope for packaging theinfusion device 100. Additionally, during assembly, the configuration ofthe needle cover 114G in the second position may reduce side stresses tothe needle cover 114G that may contribute to compromising a seal betweenthe needle-covering portion 112G and the needle manifold.

To remove the combined release liner 500 and needle cover 114G from theinfusion device 100, the patient first rotates the pull tab portion 616from the second position to the first position such that the pull tabportion 616 is substantially aligned with the needle-covering portion112G. Then, the patient grasps and pulls the pull tab portion 616.Because the release liner 500 is retained between the pull tab hooks 620and the flange 520G, such a single action removes both the release liner500 and the needle cover 114G from the infusion device 100.Subsequently, the combined release liner 500 and the needle cover 114Gare ready for disposal.

According to one embodiment, the needle cover 114 (for example, theneedle cover 114D, 114E, 114F, or 114G) is injection-molded as a singlecomponent, for example of thermoplastic elastomer (TPE). According toanother embodiment, the needle cover 114 (for example, the needle cover114D, 114E, 114F, or 114G) is injection molded in a two-shot process.For example, the pull tab portion 580 of needle cover 114D may be moldedout of polypropylene and the needle-covering portion 112D of needlecover 114D may be molded of TPE is to possess a flexibility or elasticdeformability to accommodate a press fit with the needle manifold.

Additionally, according to one embodiment, when the needle cover 114 isinstalled on the infusion device 100, for example, press fit with theneedle manifold, the needle cover 114 interlocks with the rotor 136 toprevent rotation of the rotor 136 prior to removal of the needle cover114.

As noted above, both the needle cover 114 and the release liner (e.g.,500) are removed prior to use of the infusion device 100. Accordingly,these removal actions can be integrated into a single action byemploying the described embodiments, thereby increasing patientconvenience, ease of use, and efficiency. Additionally, by optionallymaintaining a connection between the needle cover 114 and the releaseliner subsequent to removal from the infusion device 100, the describedembodiments can further increase patient convenience, ease of use, andefficiency by simplifying the disposal thereof.

Although only a few exemplary embodiments of the present invention havebeen described in detail above, those skilled in the art will readilyappreciate that many modifications are possible in the exemplaryembodiments without materially departing from the novel teachings andadvantages of this invention. Accordingly, all such modifications areintended to be included within the scope of the appended claims andequivalents thereof.

What is claimed is:
 1. A medicament delivery device, comprising: adevice body; a reservoir for containing a medicament, the reservoirbeing disposed within the body; an injection needle for penetrating apatient's skin, the injection needle being selectively displaceable froma first position within the device body to a second position, in whichat least a portion of the injection needle is disposed outside thedevice body; a pressurizing system for selectively pressurizing thereservoir; a needle cover selectively covering at least a patient end ofthe injection needle and preventing device activation when covering thepatient end of the injection needle; an adhesive liner connected withthe needle cover for removal therewith, wherein removal of the adhesiveliner and needle cover readys the device for activation; and adisplaceable activation button, wherein activation of the devicepressurizes the reservoir, establishes fluid communication between thereservoir and the injection needle, and displaces the injection needlefrom the first position to the second position.
 2. The device accordingto claim 1, wherein the adhesive liner and the needle cover are directlyconnected.
 3. The device according to claim 1, wherein: the needle covercomprises a pull tab; and in a first position, a longitudinal axis ofthe pull tab is approximately parallel to a bottom surface of the devicebody.
 4. The device according to claim 1, wherein the needle covercreates a seal around the injection needle without contacting theinjection needle.
 5. A method of operating a medicament delivery device,comprising: removing a needle cover that prevents device activation andan adhesive liner in a single motion, wherein the needle cover and theadhesive liner are connected; and pressurizing a medicament reservoir,establishing fluid communication between the reservoir and an injectionneedle, and displacing the injection needle from a first position withina device body to a second position in which at least a portion of theinjection needle is disposed outside of the device body by displacing anactivation button.
 6. The device according to claim 5, wherein theadhesive liner and the needle cover are directly connected.
 7. Thedevice according to claim 5, wherein removing the needle cover and theadhesive liner comprises pulling a pull tab of the needle cover.
 8. Thedevice according to claim 5, wherein removing the needle cover and theadhesive liner comprises pulling a pull tab of the adhesive liner.